Development and Validation of a Non-Invasive Prediction Model for Glioma-Associated Epilepsy: A Comparative Analysis of Nomogram and Decision Tree

Abstract

OBJECTIVE: Glioma-associated epilepsy (GAE) is a common neurological symptom in glioma patients, which can worsen the condition and increase the risk of death on the basis of primary injury. Given this, accurate prediction of GAE is crucial, and this study aims to develop and validate a GAE warning recognition prediction model. METHODS: We retrospectively collected MRI scan imaging data and urine samples from 566 glioma patients at the Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science from August 2016 to December 2023. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression analysis are used to determine independent risk factors for GAE. The nomogram and decision tree GAE visualization prediction model were constructed based on independent risk factors. The discrimination, calibration, and clinical usefulness of GAE prediction models were evaluated through receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA), respectively. RESULTS: In the training and validation datasets, the incidence of GAE was 34.50% and 33.00%, respectively. Nomogram and decision tree were composed of five independent radiomic predictors and three differential protein molecules derived from urine. The discrimination rate of area under the curve (AUC) was 0.897 (95% CI: 0.840-0.954), slightly decreased in the validation data set, reaching 0.874 (95% CI: 8.817-0.931). The calibration curve showed a high degree of consistency between the predicted GAE probability and the actual probability. In addition, DCA analysis showed that in machine learning prediction models, decision trees have higher overall net returns within the threshold probability range. CONCLUSION: We have introduced a machine learning prediction model for GAE detection in glioma patients based on multiomics data. This model can improve the prognosis of GAE by providing early warnings and actionable feedback and prevent or reduce pathological damage and neurobiochemical changes by implementing early interventions.